2026-08-21 統計数理研究所
図1：500万人規模のLIFE Studyを用いた高齢者の降圧薬選択と認知症リスクの比較研究。
＜関連情報＞
- https://www.ism.ac.jp/ura/press/ISM2026-09.html
- https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.71692
高齢者におけるアンジオテンシン受容体拮抗薬と認知症リスク：ターゲット試験のエミュレーション Angiotensin receptor blockers and dementia risk in older adults: A target trial emulation
Hisashi Noma, Hiroshi Sunada, Taiki Sugimoto, Takao Fujisawa, Futoshi Oda, Megumi Maeda, Haruhisa Fukuda
Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association Published:20 August 2026
DOI:https://doi.org/10.1002/alz.71692
Abstract
INTRODUCTION
Whether antihypertensive drug class influences dementia risk beyond blood pressure lowering remains uncertain.
METHODS
We emulated a target trial comparing new initiation of angiotensin receptor blockers (ARBs) versus calcium channel blockers (CCBs) among dementia-free adults aged ≥65 years in a nationwide Japanese database. Weighted discrete-time hazards models estimated intention-to-treat and per-protocol effects, accounting for censoring and death.
RESULTS
Among 52,019 eligible new users followed for a median of 3.6 years, 3524 incident dementia events occurred. ARB initiation was associated with lower all-cause dementia risk than CCB initiation (hazard ratio [HR], 0.916; 95% confidence interval [CI], 0.852–0.985), with similar achieved blood pressure. For Alzheimer’s disease (2231 events), the association was not statistically significant (HR, 0.930; 95% CI, 0.849–1.018). The association was stronger for vascular dementia (129 events; HR, 0.617; 95% CI, 0.409–0.930).
DISCUSSION
ARB initiation was associated with modestly lower dementia risk, particularly vascular dementia, versus CCB initiation.
Highlights
- Japanese target trial emulation included 52,019 older adults
- Angiotensin receptor blockers (ARBs) initiation was associated with lower dementia risk than calcium channel blockers (CCB) initiation
- The association was strongest for vascular dementia
- Alzheimer’s disease results were not statistically significant
- Achieved blood pressure was similar between treatment groups
